Suture threader assembly, suture anchor assembly, and method for threading suture

ABSTRACT

A suture threader comprises a body having first and second ends, a first suture threader extending from the body first end, and a second suture threader extending from the body second end.

This is a division of U.S. application Ser. No. 08/778,915, filed Jan.3, 1997 for "SUTURE THREADER ASSEMBLY SUTURE ANCHOR ASSEMBLY, AND METHODFOR THREADING SUTURE", now U.S. Pat. No. 5,800,447.

FIELD OF THE INVENTION

This invention to relates to surgical devices and procedures in general,and more particularly to suture threaders, suture anchor assemblies, andmethods for threading suture.

BACKGROUND OF THE INVENTION

It is known to use a suture anchor of the sort having a transverse boreextending through a proximal portion thereof so as to facilitateattachment of the suture to the anchor. It is also known to use, incombination with the suture anchor, an inserter having a lengthwise boreextending therethrough and through which may extend the suture which isattached to the suture anchor. Such a combination is shown anddescribed, for example, in U.S. Pat. No. 5,411,506, issued May 2, 1995to Goble et al. for ANCHOR DRIVER, which patent is assigned to theassignee of the present patent application, and which patent is herebyincorporated herein by reference. See also U.S. patent application Ser.No. 08/514,613, filed Aug. 14, 1995 by Goble et al. for SUTURE ANCHORASSEMBLY, which patent application is also assigned to the assignee ofthe present patent application, and which patent application is alsohereby incorporated herein by reference.

Before using the suture anchor and inserter to attach suture to a bone,the suture must be threaded through the transverse bore of the sutureanchor and through the lengthwise bore of the inserter. Typically, thesuture anchor's transverse bore is relatively short and the inserter'slengthwise bore is relatively long, thereby requiring different threaderconfigurations. By way of example, an ordinary needle threader may beused to thread the suture through the suture anchor's transverse bore,whereas a crochet-hook type of threader may be used to thread the suturethrough the inserter's lengthwise bore.

In situations where the suture is to be threaded through the sutureanchor and the inserter during initial manufacture, it may not beinconvenient for the manufacturer to use different threaders forthreading the suture through the suture anchor and the inserter.However, where the suture is to be threaded through the suture anchorand inserter at the time of use, i.e., in the operating room, it can beundesirable for the operating room personnel to use different threadersfor threading the suture through the suture anchor and through theinserter. Thus, it is deemed beneficial to have available a singlethreader which is adapted to thread suture through both (i) relativelyshort bores, such as those found in a suture anchor, and (ii) relativelylong bores, such as those found in an inserter.

OBJECTS OF THE INVENTION

Accordingly, one object of the present invention is to provide a suturethreader assembly adapted to thread suture through both suture anchorsand inserters.

A further object of the present invention is to provide a suture anchorassembly including a suture anchor, an inserter, a suture, and a suturethreader assembly for threading the suture through both the sutureanchor and the inserter.

A still further object of the present invention is to provide a methodfor threading suture through a suture anchor and an inserter.

SUMMARY OF THE INVENTION

These and other objects of the present invention are addressed by theprovision and use of a novel suture threader assembly comprising a bodyhaving first and second ends, a first suture threader extending from thefirst end of the body, and a second suture threader extending from thesecond end of the body.

The objects of the present invention are further addressed by theprovision and use of a novel suture anchor assembly comprising a sutureanchor having a transverse first bore extending through a proximal endthereof, and an inserter having an axial second bore extendingtherethrough, and a seat disposed in the second bore for receiving thesuture anchor. The suture anchor assembly further includes a suture forthreading through the first bore and for threading through the secondbore and out a proximal end of the inserter, and a suture threaderassembly for threading the suture through the first bore so as toconnect the suture to the suture anchor and for thereafter threading thesuture through the second bore such that the suture can be used to pullthe anchor onto its seat in the second bore.

The objects of the present invention are still further addressed by theprovision and use of a novel method for threading suture through a firstbore extending transversely through a suture anchor and for threadingthe suture through a second bore extending lengthwise through aninserter. The method includes the steps of providing a suture threaderassembly comprising a body having first and second ends, a first suturethreader extending from the first end of the body, and a second suturethreader extending from the second end of the body. The suture threaderassembly is used by manipulating the body so as to pass the first suturethreader through the first bore, positioning the suture in the firstsuture threader, manipulating the body so as to return the first suturethreader through the first bore, whereby to pass the suture through thefirst bore so as to facilitate attachment of the suture to the anchor,and then removing the first suture threader from the suture. The suturethreader is further used by manipulating the body so as to pass thesecond suture threader into a proximal end of the second bore, throughthe second bore, and out a distal end of the second bore, positioningthe suture in the second suture threader, and manipulating the body soas to return the second suture threader through the second bore, wherebyto pass the suture through the second bore and out the proximal end ofthe second bore.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other objects and features of the present invention will bemore fully disclosed or rendered obvious by the following detaileddescription of the preferred embodiments of the invention, which are tobe considered together with the accompanying drawings wherein likenumbers refer to like parts, and further wherein:

FIG. 1 is a side view of a suture threader assembly formed in accordancewith the present invention;

FIG. 2 is an end view of one end of the suture threader assembly shownin FIG. 1;

FIG. 3 is an enlarged side view showing the other end of the suturethreader assembly shown in FIG. 1;

FIG. 4 is a side elevational view of a suture anchor of the sort whichthe suture threader assembly of FIGS. 1-3 might be used with;

FIG. 5 is a proximal end view of the suture anchor of FIG. 4;

FIG. 6 is a side view of an inserter of the sort which the suturethreader assembly of FIGS. 1-3 might be used with;

FIG. 7 is an end view of the proximal end of the same inserter;

FIGS. 8-14 are diagrammatic illustrations showing the suture threaderassembly's first suture threader threading suture through the sutureanchor;

FIGS. 15-19 are diagrammatic illustrations showing the suture threaderassembly's second suture threader threading suture through the inserter;and

FIG. 20 is a schematic illustration showing a suture anchor, inserterand suture, wherein the suture has been appropriately threaded throughthe suture anchor and inserter, and the suture anchor is mounted in theinserter.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring to the drawings, it will be seen that an illustrativeembodiment of the present invention includes a suture threader assembly5 (FIG. 1), a suture anchor 100 (FIGS. 4 and 5), an inserter 200 (FIGS.6 and 7), and a suture 300 (FIGS. 11-14 and 17-20).

Looking next at FIGS. 1-3, suture threader assembly 5 includes a body 10having first and second ends 15 and 20, respectively. A first suturethreader 25 extends from first end 15 and a second suture threader 30extends from second end 20.

First suture threader 25 comprises a substantially closed first loop 35of a first wire-like material, and a first neck portion 40 of the samefirst wire-like material. Neck portion 40 interconnects first loop 35 offirst suture threader 25 with first end 15 of body 10.

Second suture threader 30 comprises a substantially closed second loop45 of a second wire-like material, and a second neck portion 50 of thesame second wire-like material. Neck portion 50 interconnects secondloop 45 of second suture threader 30 with second end 20 of body 10.Second neck portion 50 is significantly longer than first neck portion40. By way of example but not limitation, second neck portion 50 mightbe on the order of 10 times the length of first neck portion 40.

Each of the first and second loops 35, 45 substantially comprises aquadrilateral having a point 51, 55 at an end 60, 65 most removed fromthe body's ends 15, 20. Each of the first and second loops 35, 45defines (i) a longitudinal axis 70, 75, and a (ii) transverse axis 80,85 extending perpendicular to the respective longitudinal axes 70, 75.

First suture threader 25 is provided with a length L1 (as measuredbetween its end 60 and the body's first end 15) which is substantiallyshorter than the second suture threader's length L2 (as measured betweenits end 65 and the body's second end 20). Transverse axis 80 of firstloop 35 is disposed closer to the body's first end 15 than to the firstloop's end 60. On the other hand, transverse axis 85 of second loop 45is disposed closer to its end 65 than to the body's second end 20. Eachof the first and second loops 35, 45 is provided with side points 90which are disposed substantially along the transverse axes 80, 85. Theside points 90 of first loop 35 are thus closer to body 10 than to end60, and side points 90 of second loop 45 are closer to end 65 than tobody 10.

The first and second materials of first and second suture threaders 25,30 may be metal wire, such as stainless steel, or a plastic materialwire, preferably round in cross-sectional configuration. The diameter ofthe wire-like material of first suture threader 25 is substantially lessthan the diameter of the wirelike material of the second suture threader30, as will be discussed further hereinbelow.

In FIGS. 4 and 5, there is shown a suture anchor 100, which is typicallymade of metal. Suture anchor 100 is of a generally cylindricalconfiguration and is provided with a distal end 105, which is pointed orotherwise configured so as to penetrate bone. At a proximal end 110thereof, suture anchor 100 is reduced in diameter so as to provide aproximally-facing annular flange 115 and a proximally-extending dowel120. Preferably dowel 120 has a non-circular (e.g., hexagonal)cross-section, whereby anchor 100 may be rotated by a deployment tool(e.g., inserter 200). Dowel 120 terminates in a proximal end surface123. The dowel 120 defines a transverse bore 125 extending therethrough,side to side. Bore 125 is adapted to receive suture 300, as will befurther described hereinbelow. Preferably suture anchor 100 is similarto the sort of anchor disclosed in the aforementioned U.S. patentapplication Ser. No. 08/514,613.

Referring next to FIGS. 6 and 7, it will be se en that inserter 200 isprovided with a longitudinal bore 205 extending lengthwise therethroughand stepped with a front broach 207 so as to provide a distally-facingannular flange 210 defining a suture anchor seat for receiving sutureanchor 100. Preferably broach 207 has a non-circular (e.g., hexagonal)cross-section corresponding to the cross-sectional shape of the anchor'sdowel 120, whereby inserter 200 can be used to rotate anchor 100 so asto deploy the anchor in bone, in the manner well known in the art.Inserter 200 terminates in a distal end surface 212. Preferablylongitudinal bore 205 includes a countersink 215 near the proximal endof inserter 200, so as to facilitate entry of the second suture threader30 into the inserter, as will hereinafter be discussed. Thus it will beseen that inserter 200 generally comprises an elongated bore passingfrom one end of the inserter to the other, with the distal end of thatelongated bore being configured to receive the suture anchor, and theproximal end of that elongated bore being configured to facilitate entryof second suture threader 30 into that elongated bore.

It is to be appreciated that the inserter's longitudinal bore 205 isgenerally significantly longer than the suture anchor's transverse bore125; and the inserter's longitudinal bore 205 is generally alsosignificantly wider than the suture anchor's transverse bore 125.

In operation, the suture threader assembly 5 is typically used first toattach suture 300 to suture anchor 100 (FIGS. 8-14). More particularly,an operator grasps suture threader assembly body 10 and directs firstsuture threader end 60 into suture anchor bore 125 (FIG. 8). As firstloop 35 is urged into bore 125, the loop 35 compresses (FIG. 9),permitting loop 35 to travel through bore 125. As noted above, the firstloop 35 is made of metal, such as stainless steel, or a plasticmaterial, which permits the first loop to compress into bore 125. Afirst loop material found suitable is round 304 stainless steel wire,1/2 hard, of a diameter of about 0.003 inch.

Upon emerging from bore 125, first loop 35 may naturally regainsufficient of its loop configuration (FIG. 10) to permit threadingsuture 300 therethrough (FIG. 11). If not, the operator may easily pryopen first loop 35. Once suture 300 is in first loop 35, loop 35 isdrawn back by manipulation of body 10 through bore 125 (FIG. 12) so asto thread the suture through the suture anchor's bore 125 (FIG. 13). Oneend of the suture may then be pulled through the bore 125 to slidablysecure the suture 300 to anchor 100 (FIG. 14).

Having slidably secured suture 300 to suture anchor 100, it is desirableto then thread suture 300 through inserter 200. However, due to theelongated configuration of inserter 200, first suture threader 25 isinadequate for this purpose and second suture threader 30 must be used.More particularly, the operator, by grasping body 10, directs secondloop point 55 into inserter 200 at the proximal countersink 215 (FIG.15) and then down the length of bore 205. Because of the wire-likestructure of second loop 45, loop 45 readily compresses to enter andpass through the inserter countersink 215 and then bore 205 (FIG. 16).Like the first suture threader 25 discussed above, the second suturethreader 30 may be made of a metal or plastic wire-like material,preferably round 304 stainless steel wire, 1/2 hard, of about 0.012 inchdiameter. The second loop 45 is of a material and of a dimensionsuitable for permitting collapse of loop 45 upon entering and passingthrough countersink 215 and bore 205 and for self-expansion of loop 45upon emerging from bore 205 and broach 207 (FIG. 17). Again, if loop 45does not naturally re-expand to a size sufficient to easily receive asuture, another tool (not shown) can be used to pry the loop open. Bothfree ends of suture 300 are then threaded through second loop 45 (FIG.17). Next, the loop is drawn back through broach 207, bore 205 (FIG.18), and out the proximal countersink 215 (FIG. 19). The suture threaderassembly 5 is then disengaged from suture 300.

By grasping the two free ends of suture 300, the operator may then drawsuture anchor 100 into distal broach 207 until the anchor's annularflange 115 engages the inserter's distal end surface 212 and theanchor's proximal end surface 123 engages the inserter's annular flange210 (FIG. 20) so as to seat anchor 100 in inserter 200. Suture anchor100 and inserter 200 may then be used in ways well known in the art toattach suture 300 to a bone.

After suture 300 has been threaded through suture anchor 100 andinserter 200, the suture threader assembly 5 may be disposed of.Inasmuch as body 10 is typically made of a rigid plastic material andthe remainder of the suture threader assembly 5 is made of a metal orplastic wire, the assembly is inexpensive to make and readily disposablewithout undue cost.

It is, of course, possible to use the suture threader assembly 5 inconjunction with suture anchors and inserters other than those shown inFIGS. 4-20. By way of example, suture threader assembly 5 might be usedwith a suture anchor and inserter such as shown in the aforementionedU.S. Pat. No. 5,411,506, or the suture threader might be used with othersuture anchors and/or inserters. Among other things, it should be notedthat suture threader assembly 5 might be used with suture anchorscomprising means other than screw threads for retaining the sutureanchor in bone, e.g., the assembly might be used with suture anchorscomprising barbs or expandable bodies. Suture threader assembly 5 mightalso be used with suture anchors having a suture-receiving boreextending in a direction other than transverse, e.g., the suturethreader assembly 5 might be used with a suture anchor having asuture-receiving bore extending in a longitudinal direction along thelength of the anchor. In short, suture threader assembly 5 might be usedwith any suture anchor system of the sort comprising a suture anchorhaving a relatively short bore and an inserter having a relatively longbore.

There is thus provided a suture threader which serves the dual purposesof threading suture through both suture anchors and inserters. There isfurther provided a suture assembly including a suture anchor, a suture,an inserter, and a suture threader for threading the anchor and theinserter. There is still further provided a method for fixing suture toa suture anchor and passing the suture through an inserter, using onetool for both tasks.

It is to be understood that the present invention is by no means limitedto the particular construction and method steps herein disclosed and/orshown in the drawings, but also comprises any modifications orequivalents within the scope of the claims.

What is claimed is:
 1. A suture anchor assembly comprising:a sutureanchor having a transverse first bore therethrough proximate a proximalend thereof; a suture anchor inserter having an axial second boretherethrough and a suture anchor seat disposed in said second bore forreceiving and retaining said suture anchor; a suture for disposition insaid first bore and for extending through said second bore and out aproximal end of said inserter; and a suture threader assembly forthreading said suture through said first bore to connect said suture tosaid anchor and for thereafter threading said suture through said secondbore such that said suture is operable to pull said anchor into saidsecond bore and onto said anchor seat.
 2. A suture anchor assemblyaccording to claim 1 wherein said anchor is provided with distal andproximal ends, said anchor distal end being configured to penetratebone, said anchor being generally cylindrically-shaped, and saidproximate end being of reduced diameter so as to provide aproximal-facing annular flange on said anchor.
 3. A suture anchorassembly according to claim 2 wherein said suture anchor seat of saidinserter comprises a distally-facing annular flange engageable by saidsuture anchor annular flange to seat said suture anchor in said insertersecond bore.
 4. A suture anchor assembly according to claim 1 whereinsaid first bore extends from side-to-side of said suture anchor reduceddiameter portion.
 5. A suture anchor assembly according to claim 1wherein said suture threader assembly comprises a body having first andsecond ends, a first suture threader extending from said body first end,and a second suture threader extending from said body second end, saidfirst suture threader being adapted for said threading of said suturethrough said first bore, and said second suture threader being adaptedfor said threading of said suture through said second bore.
 6. A sutureanchor assembly according to claim 5 wherein said first suture threadercomprises a substantially closed first loop of first wire-like materialand said second suture threader comprises a substantially closed secondloop of second wire-like material.
 7. A suture anchor assembly accordingto claim 6 wherein each of said loops substantially comprises aquadrilateral having a point at an end most removed from said body.
 8. Asuture anchor assembly according to claim 7 wherein each of said loopshas opposed side points, said side points in said first loop beingcloser to said body than to said First loop end, and said side points ofsaid second loop being closer to said second loop end than to said body.9. A method for fixing suture to a suture anchor of the sort having afirst transverse bore therethrough and for passing said suture through asecond bore extending lengthwise through a suture anchor inserter, saidmethod comprising the steps of:providing a suture threader assemblycomprising a body having first and second ends, a first suture threaderextending from said body first end, and a second suture threaderextending from said body second end; manipulating said body to pass saidfirst suture threader in a first direction through said first bore;positioning a portion of said suture in said first suture threader;manipulating said body to pass said first suture threader in a seconddirection through said first bore so as to pass said suture through saidbore to facilitate attachment of said suture to said anchor; removingsaid suture from said first suture threader; manipulating said body topass said second suture threader into a proximal end of said secondbore, through said second bore, and out a distal end of said secondbore; positioning a portion of said suture in said second suturethreader; and manipulating said body so as to return said second suturethreader through said second bore distal end and through said secondbore so as to pass said suture through said second bore and out saidproximal end of said second bore.
 10. A method according to claim 9wherein said first suture threader comprises a first loop having a firstpoint remote from said body and said second suture threader comprises asecond loop having a second point remote from said body;said passing ofsaid first suture threader in said first direction through said firstbore comprises urging said first point through said first bore tocompress said first loop which, upon emerging from said first bore, isexpandable to again form a loop configuration; said positioning of saidsuture in said first suture threader comprises passing said suture intosaid first loop; passing said suture through said first bore comprisespulling said first suture threader, with said suture therein, backthrough said first bore for said attachment of said suture to saidsuture anchor; said passing of said second suture threader distallythrough said second bore comprises inserting said second loop end intosaid proximal end of said second bore and urging said second pointthrough said second bore to compress said second loop which, uponemerging from said second bore at said distal end thereof, expands toform a loop configuration; said positioning said suture in said secondsuture threader comprises passing said suture into said second loop; andsaid returning of said second suture threader through said second borein a proximal direction comprises pulling said second suture threader,with said suture therein, back through said second bore for stringingsaid suture through said second bore and out said proximal end of saidsecond bore.